Search PubMed⌕ Search

Biomedical subjects

J Badoual

Publications and source records attributed to J Badoual.

At least 37 records · Page 2Linked to original sources
PubMed1994

Allergy to nondairy proteins in mother's milk as assessed by intestinal permeability tests.

The intestinal permeability test is a noninvasive method which, when done during a food provocation procedure, can detect the deleterious effect of food on the intestinal mucosa in allergic children. We report on a 1-month-old breast-fed boy with a history of regurgitation, diarrhea, difficult feeding, and malaise suggesting food allergy. Intestinal permeability tests were done with the mother's milk and showed breast-milk-induced alterations of intestinal permeability. No improvement occurred in the child's clinical symptoms or in the results of the intestinal permeability test when the mother withdrew dairy products from her diet. Disappearance of the child's symptoms and normalization of intestinal permeability during provocation with the milk were obtained after elimination of egg and pork from the mother's diet. This observation suggests that dietary proteins different from cow's milk antigens may be transferred to breast milk and induce adverse reactions in hypersensitive infants.

Animals↗
PubMed1993

Use of pefloxacin after failure of initial antibiotic treatment in children with severe salmonellosis.

Sixteen children (7 males, 9 females) aged 0.1 to 9.5 years (mean 3.6 years) who were hospitalized for severe salmonella infection were treated with conventional antibiotics. In nine children disappearance of fever and bloody diarrhea was obtained 2 to 4 days after the beginning of antibiotic therapy. Although the antibiotic administered was active against the pathogen, after 4 to 8 days the seven other children experienced clinical failure of the initial therapy, with a temperature of over 39 degrees C, bloody diarrhea and positive stool culture in all cases. The seven Salmonella strains isolated (1 S. typhi, 1 S. paratyphi B, 2 S. enteritidis, 3 S. typhimurium) were all sensitive to ampicillin, cotrimoxazole and pefloxacin. These seven children were then given 12 mg/kg/day of pefloxacin orally for 7 days. Apyrexia and complete resolution of diarrhea were obtained within 1 to 3 days in all cases without side effects. Trials are needed to determine the safety and toxicity of quinolones in children, however short-term therapy with pefloxacin could be useful in children with severe invasive salmonellosis after failure of conventional antibiotic therapy.

4-Quinolones↗
PubMed1993

The immune response in iron-deficient young children: effect of iron supplementation on cell-mediated immunity.

The effects of iron deficiency on immunity remain controversial. This study was designed to assess the impact of iron supplementation on the immune status, in 81 children aged 6 months-3 years, at high risk for iron deficiency, using a longitudinal double blind randomised and placebo-controlled study. Lymphocytes of iron-deficient children produced less interleukin-2 in vitro. Iron supplementation for 2 months increased mean corpuscular volume, serum ferritin and serum transferrin, but had no effect on the parameters of T-cell mediated immunity. The lower interleukin-2 levels in iron-deficient suggest that cell-mediated immunity may be impaired in iron deficiency.

Anemia, Hypochromic↗
PubMed1993

Rotavirus induces alpha-interferon release in children with gastroenteritis.

alpha-Interferon (IFN) blood levels were studied in 38 children hospitalized for rotavirus gastroenteritis. During rotavirus infection, a peak of systemic alpha-IFN was observed within 2 days of onset of symptoms. There was a significant positive correlation between alpha-IFN levels and the number of vomiting episodes (p = 0.0003) but not with duration of vomiting, maximal temperature, and duration of fever. alpha-IFN levels were higher in children with peripheral cyanosis compared with children without peripheral cyanosis (p = 0.005) and tended to be higher in children with diarrhea of < 3 days' duration compared with those with diarrhea lasting > 4 days (p = 0.06). alpha-IFN could be partly responsible for the severity of such initial symptoms as vomiting and peripheral cyanosis in rotavirus gastroenteritis and could play a role in recovery from diarrhea.

Female↗
PubMed1993

[The effect of human albumin in association with intensive phototherapy in the management of neonatal jaundice].

BACKGROUND: The effectiveness of phototherapy in lowering serum bilirubin levels in neonates varies inversely with the rate and degree of hemolysis. Combining this therapy with albumin perfusion could enhance its effectiveness. This study examines total, unconjugated and unbound fractions of bilirubin in infants treated by phototherapy alone or by phototherapy plus albumin. PATIENTS AND METHODS: The files of 211 neonates treated from January 1990 to March 1991 for severe neonatal jaundice were analysed. Jaundice was due to ABO incompatibility in 113 cases and hereditary hemolytic anemia in 6 cases; its cause was unknown in 92 patients. Other causes of jaundice such as Rh incompatibility, premature delivery before 34 gestational weeks and neonatal infections were excluded from the study. All 211 neonates were given phototherapy from admission with similar light energy. 114 babies (group I) received only phototherapy, while the 97 others (group II) were also given human albumin, (1.5 g/kg), during the first 2 hours of phototherapy. RESULTS: The decrease in serum unconjugated and unbound bilirubin after 4 hours of phototherapy was 34% in group I and 45% in group II (p < 0.0005). There was no difference between both groups after 24 hours of phototherapy. Other factors such as the initial concentration of serum unconjugated and unbound bilirubin, age at the onset of therapy, and ethnic skin color also influenced the decrease in bilirubin after 4 and 24 hours of phototherapy, in addition to albumin perfusion. CONCLUSIONS: Albumin perfusion plus phototherapy appears to induce a rapid and early decrease in unconjugated, unbound bilirubin, the fraction that is potentially neurotoxic, while phototherapy alone acts over a longer period.

Analysis of Variance↗
PubMed1993

[Candida meningitis, in a premature infant, treated with liposomal amphotericin B and flucytosine].

BACKGROUND: Candida meningitis in infancy is becoming more common. Its treatment is difficult and may benefit from liposomal amphotericin B. CASE REPORT: A preterm infant developed necrotizing enterocolitis on day 4. Antibiotic therapy included cefotaxime, gentamicin, vancomycin and metronidazole; a central catheter was inserted for nutrition. An acute meningitis developed on day 17 and CT scan showed several brain abscesses. Candida albicans was recovered from the feces, urine and gastric fluid on day 19 and the infant was treated with fluconazole. This drug was replaced by amphotericin B and fluorocytosin when CSF studies a few days later showed persistent meningitis and the presence of Candida albicans. There was no sign of endocarditis. 3 days later, amphotericin B was replaced by liposomal amphotericin B at a dose of 3 mg/kg/day, while the initial catheter was removed. The CSF values and CT scan images gradually improved on this treatment. Liposomal amphotericin B and fluorocytosin treatment was interrupted on day 94, and replaced by oral fluconazole for 5 weeks. These drugs were very well tolerated and further studies at 6 months of age showed that the infant was normal, with no sign of immune deficiency. CONCLUSION: This infant showed several indications of a bad prognosis. But treatment of Candida meningitis liposomal amphotericin B seemed to greatly improve the management of this severe infection.

Amphotericin B↗
PubMed1993

[C2 deficiency discovered in pneumococcal meningitis].

BACKGROUND: Congenital deficiencies of complement system proteins are rare. Patients with C2 deficiency have a high incidence of vascularitis syndromes. Most patients with this deficiency have no problems with increased susceptibility to infection, most commonly due to pneumococci, presumably because of the protective function of the alternative pathway. CASE REPORT: A 22 month-old girl was admitted because of acute meningitis and otitis. She had had 2 episodes of otitis media at the age of 1 year. Analysis of the CSF showed that this meningitis was due to pneumococcal infection. Recovery was complete after 15 days of antibiotic therapy. Total hemolytic complement activity (CH50) was low during the infection; one month later, the CH50 value was about zero as was C2, while C3 and C4 were normal. The patient was given polyvalent pneumococcal and anti-Haemophilus vaccines plus prophylactic penicillin G. Laboratory tests for systemic lupus erythematosus were negative. CONCLUSION: A defect of complement function should be suspected in any patient with severe of recurring pyogenic infections. Complement disorders can be detected one month later by means of the relatively simple hemolytic complement assay.

Complement C2↗
PubMed1993

[A rare cause of hypercalcemia: familial hypocalciuric hypercalcemia].

BACKGROUND: Familial hypocalciuric hypercalcemia is a rare disease with autosomal dominant transmission. Its basic defect is unknown and it requires no treatment. CASE REPORT: A 4 month-old girl was admitted for unexplained crying. She was found to have hypercalcemia (2.8 mmol/l) and later values of blood calcium were 3, 3.1 and 3 mmol/l. The serum free ionic calcium level was also elevated. The serum concentrations of protein, phosphorus, magnesium and the alkaline phosphatase activity were all normal. Serum concentrations of 25-(OH)-D3, 1.25-(OH)-2-D3 and PTH were also normal. The urinary calcium/creatinine ratio was normal and the urinary calcium excretion was 1.08 mg/kg/d. Screening of family members showed hypercalcemia in the father (2.8 mmol/l) and a brother aged 7 years (2.9 mmol/l). Short-term treatment with disodium etidronate lowered the serum calcium level to normal, but hypercalcemia reappeared once the treatment was discontinued. CONCLUSIONS: This asymptomatic familial hypercalcemia has the characteristics of familial hypocalciuric hypercalcemia. There was no associated endocrine disorder. Screening of family members is worthwhile.

Calcium↗
PubMed1993

[Severe megaloblastic anemia in child breast fed by a vegetarian mother].

The case of a 15-month-old, strictly breast-fed infant whose mother had been following a vegetarian diet for ten years is reported. The infant had severe megaloblastic anemia with an arrest in growth, hypotonia, and failure of psychomotor development. The very low levels of vitamin B12 in the infant's serum and mother's milk confirmed the diagnosis. Management of such cases consists in administration of vitamin B12 supplements, with a blood transfusion if needed. Other concomitant deficiencies should be looked for. The outcome is rapidly favorable. The patient reported here is now four years of age and has normal statural growth and psychomotor development.

Anemia, Megaloblastic↗
PubMed1992

Impairment of lung diffusion capacity in Schönlein-Henoch purpura.

Twenty-nine children with typical Schönlein-Henoch purpura (SHP) were tested at the initial phase of the disease for respiratory function. Of the 29 patients, 28 had a decrease of lung transfer for carbon monoxide (TLCO) as measured by a steady-state method. Lung volumes and blood gas values were normal; slight radiologic signs of interstitial lung involvement were observed in 18 of 26 patients. There was a decrease in TLCO to 56.8% of normal values for height and gender and to 58.5% when normal values were volume-adjusted to functional residual capacity. In 19 of 25 patients, TLCO measurements were performed at 3-month intervals during follow-up. In all cases, normalization of TLCO values was observed only after complete clinical recovery from SHP. All children with persisting symptoms, even limited to microscopic hematuria or slight proteinuria, had low TLCO values. In one patient low TLCO during follow-up preceded a late relapse of SHP in the form of acute nephritic disease with characteristic IgA deposits on renal biopsy. We conclude that low TLCO in SHP is probably related to alteration of the alveolar-capillary membrane by circulating immune complexes. This noninvasive technique may be useful in diagnosis, and during the follow-up of the disease as an early indicator of reactivation.

Carbon Monoxide↗
PubMed1992

[Treatment of malaria in children in France].

Currently, most of the subjects presenting with Plasmodium falciparum malaria in France come from areas where chloroquine resistance has already been reported. Treatment of uncomplicated malaria should consist of oral administration of either quinine or mefloquine or halofantrine. In children, halofantrine seems to be the treatment of choice at any age. The prognosis of cerebral malaria depends on how fast the diagnosis is made and the treatment is undertaken. The detection of clinical and biological risk factors is crucial. The treatment of cerebral malaria is based on quinine perfusion administered according to pharmacokinetic data.

Antimalarials↗
PubMed1992

[Neonatal herpes: recurrence after treatment with acyclovir].

A case of cutaneous herpes relapse with meningitis is reported in a 1.5 month-old infant treated during the first three weeks of life with acyclovir (ACV) for a neonatal herpes infection. Such a relapse has previously been described in older children as well as in adults. In this case report, there was immunological response to herpes virus infection, 2.5 months after the onset of the infection. The relapse is discussed taking into account the mechanism of action of ACV, the age of the patient and the immunological response profile. Because of the high risk of neurological involvement, we suggest that the relapse should be treated with ACV for a period of time longer than actually recommended.

Acyclovir↗
PubMed1992

[Neonatal cervical cord compression by a staphylococcal abscess].

In a small for date premature newborn infant, septicemia caused by Staphylococcus aureus was observed on day 16. In spite of an appropriate antimicrobial therapy, proteins of inflammation serum levels remained elevated for 2 weeks. The occurrence of cervical cord compression which could be related to a staphylococcal abscess explained the persisting inflammatory process. After puncturing of the abscess, immobilization and prolonged antibiotic treatment, outcome was favorable. This case demonstrates the difficulty of preventing abscesses related to staphylococcal septicemias and reports a very unusual site of abscess which could be well localized using MRI.

Abscess↗